The Register Citizen (Torrington, CT)
At 91, aggressive cancer patient gets delicate, personalized treatment
Bob Haseltine is not a typical case. At 91-yearsold, he is blind and lives with his daughter, Melanie Master.
He already overcame prostate cancer with radiation 20 years ago, so when he was diagnosed with bladder cancer this year, his doctor did not perform the standard procedure of taking out the bladder and fashioning a new one out of intestinal lining.
“I know a big surgery will help his pathology, but will it help his quality of life?” said Dr. David Ahlborn, Urologic Oncologist and Director of Robotics at the Fairfield Region of Hartford HealthCare. “He’ll feel like garbage for months, and have I done him any service by putting him through this when, right now, he’s able to continue to live his life? I would be robbing him of this time of his life right now if we did major surgery.”
Without that long, hard surgery, the next best road would be chemotherapy and radiation, but Haseltine has reached his lifetime limit of radiation. So Ahlborn, with the help of Hartford HealthCare’s Tallwood Urology & Kidney Institute, went in a different direction performing a series of resections on Haseltine, grabbing as much of the tumor as he could each time.
So far, Haseltine has had two resections, which require shorter surgeries and just one night’s stay at St. Vincent’s Medical Center. But Ahlborn says he’ll most likely need more.
“He doesn’t have your run-of-the-mill cancer. It’s a bladder cancer that’s turning into a different type of tissue altogether. It’s still localized, but it’s very aggressive,” Ahlborn said. “The problem is that the tumor can prevent drainage of the kidneys to the bladder or the bladder from draining through the prostate. One of the treatments that will be integral in his care will be repeat resections.”
For Haseltine, the problem came on suddenly. One day he was feeling fine, and the next his bladder was spasming. He was in pain, so they went to the emergency room, his daughter said.
“On Jan. 22, I got home from a hockey game, and he was having trouble going to the bathroom. We found blood on the bathroom floor, and he couldn’t see it because he is blind,” Master said. “We called his doctor, and they told us to go to the ER. Dr. Ahlborn [came in on Monday] and stayed on the whole time.”
While a doctor would typically look inside the bladder with a small camera, due to some anatomical variations, Ahlborn had to drain the organ and insert a catheter. While doing so he also took a biopsy, knowing Haseltine would have to come back for resections.
“He has high-grade aggressive cancer, and the follow up depends on a lot of things: his age, his health, his prior radiation — we are limited in what we can do for him,” Ahlborn said.
But Haseltine isn’t affected by the diagnosis, and the treatment leaves him comfortable and secure.
“I never really thought about it being cancer. It was an exploratory operation, so when they discovered it and cleaned it out, it was news to me,” he said. “I still don’t think of it as cancer or take it too seriously. Maybe that’s good. I have a good disposition about it.”
This is where the Hartford HealthCare plan stands out, Ahlborn says.
“His care is not straightforward. This is a complex case. This is not the kind of case your normal hospital is going to handle well. It highlights how dedicated we are to making sure that families and people get healthcare that gives them access to the cutting edge of what’s available, but also with the perspective of preserving quality of life in a way they can understand and in a way that works with patients where they are to figure out their goals.”
As for Haseltine, his life is moving along just as he likes it. He still walks every afternoon, and his hospital stays are short and pleasant.
“The president of St. Vincent’s sits behind me in church on Sunday, and he came in to see me,” Haseltine said. “I love the nurses. I get to play my harmonica in the hospital, and Dr. Ahlborn was superior. Calm and genuine, he’s the kind of man I would love to go out and play tennis with. He made me feel very comfortable and has a sense of humor. It’s been a valuable experience with wonderful people.”